Cancer in children is almost always met with an initial shock, but you will need to make cancer care decisions quickly.

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Childhood cancer strikes about one out of 300 children before the age of 19. When the cancer patient is a child, normal life stops for the whole family — parents need to be away from work, siblings are separated. For caregivers of children with cancer, the diagnosis may be numbing, with parents feeling confused and shocked. Although it may seem like life is at a standstill, important decisions need to be made quickly about the cancer patient's treatment.

Cancer in Children: Handling the Diagnosis

If you don’t believe the cancer diagnosis and go into denial, it’s okay — these are normal first reactions, a defense mechanism that helps people cope with the initial shock. But you will still need to respond to the situation and take action. These strategies will help you focus on your child’s needs:

Take notes. When parents first talk about the cancer patient's diagnosis and treatment, it may be hard to concentrate and remember what was said. It's a good idea to take notes and bring along friends or family members to doctor visits.

Anticipate emotions. Understand that shock, disbelief, fear, and anxiety are normal reactions you will experience. Knowing to expect these emotions and talking about them openly will help keep them from clouding your judgment.

Consider getting a second opinion. Childhood cancer is a rare disease. Your family doctor or pediatrician will usually refer you to a nearby medical center. You have the right to get a second opinion and it is important to be confident in the cancer patient's treatment team. But remember that time is important. Sometimes parents' denial can lead them to doubt any opinion, and that can delay treatment, and how well the child responds to that treatment.

Take care of yourself. Make sure that you eat properly, get enough sleep, and pay attention to your appearance. Parents and other caregivers who maintain normal routines can better support the child with cancer, and the child will be reassured to see that you are acting normally.

Cancer in Children: Starting Treatment

Once you have settled on a treatment plan, the most important decision is to find the best treatment available. In almost all cases, this will be at a childhood cancer center. The American Cancer Society and the National Cancer Institute both recommend children's cancer centers because they provide a team approach for childhood cancer patients. The team usually includes doctors and nurses who have special training in treating cancer in children, as well as social workers, teachers, psychologists, nutritionists, and recreation therapists. Here are some other things you should know:

Take an active role. As the caregiver, you are responsible for giving consent and making important treatment decisions. This means learning as much as you can, asking lots of questions, and developing positive relationships with the treatment team members.

Consider participating in a clinical trial. Most children's cancer centers are members of the Children's Oncology Group. This group, which is supported by the National Cancer Institute, offers cancer patients the latest treatment options. Clinical trials are always optional and you will need to carefully discuss the benefits and risks with your treatment team. About 55 to 65 percent of children with cancer under age 14 participate in a clinical trial.

Keep up with schoolwork. Children's cancer centers have education coordinators and teachers specially trained to help children with cancer continue their schooling during treatment. School provides them with a normal world apart from cancer.

Take advantage of support services. Children's cancer centers are aware that when a child is the cancer patient, the whole family is affected. Your family will benefit from the education, support, and counseling offered at the cancer center. Many treatment centers offer support groups for parents, siblings, and children with cancer.

While you may feel that your world is spinning out of control, the support available to families of children with cancer can help you make it through the initial shock and be in a better frame of mind to participate in your child's treatment decisions.

The most important thing to know is that treatment of childhood cancers has improved dramatically in the past 25 years. The five-year survival rate for all childhood cancers — the percentage of youngsters still alive five years after diagnosis — is about 80 percent.

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